| NPI | 1174017230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180014044) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178013744) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2024-06-27 |